Miami Recruiters Admit $20M Medicare Scam

MIAMI, FL – Four patient recruiters have confessed to their roles in a brazen $20 million healthcare fraud scheme centered around the now-defunct Trust Care Health Services Inc. The scheme involved billing Medicare for medically unnecessary home health and physical therapy services, preying on vulnerable beneficiaries for illicit profit.

Estrella Perez, 57, and Solchys Perez, 34, both pleaded guilty to conspiracy to commit health care fraud before U.S. District Judge Darrin P. Gayles of the Southern District of Florida. Abigail Aguila, 40, entered a guilty plea to conspiracy to defraud the United States and receive health care kickbacks. A fourth defendant, Monica Macias, 52, previously pleaded guilty on June 17, 2014, to similar charges before U.S. Magistrate Judge Chris M. McAliley. All four face sentencing on or before September 18, 2014.

Court documents reveal the defendants operated as patient recruiters for Trust Care, a Miami-based home health agency. Instead of providing legitimate care, Trust Care was allegedly a front for systematically defrauding the Medicare program. The agency allegedly billed for services that were never rendered or were not medically necessary. The recruiters weren’t just finding patients; they were actively incentivized to do so through a network of kickbacks and bribes.

The Perez women went further, allegedly paying kickbacks to individuals within doctors’ offices and clinics. These bribes secured fraudulent prescriptions, plans of care, and medical certifications for patients they had recruited – essentially creating the illusion of legitimate medical need. Trust Care then used this falsified paperwork to submit claims to Medicare, siphoning off millions in taxpayer dollars. The scheme ran from approximately March 2007 through at least January 2010, racking up over $20 million in fraudulent claims.

Federal investigators from the FBI and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) uncovered the scheme as part of the Medicare Fraud Strike Force. The investigation was spearheaded by U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida and Assistant Attorney General Leslie R. Caldwell of the Department of Justice’s Criminal Division. Medicare ultimately paid out over $15 million on these bogus claims before the scheme was busted.

This case is a stark reminder of the relentless efforts to combat healthcare fraud. The Medicare Fraud Strike Force, now active in nine cities nationwide, has charged nearly 1,900 defendants responsible for over $6 billion in fraudulent billing. Trial Attorneys A. Brendan Stewart and Anne P. McNamara of the Criminal Division’s Fraud Section are prosecuting the case. Citizens are encouraged to report suspected fraud at www.stopmedicarefraud.gov. More information can be found on the website of the United States Attorney’s Office for the Southern District of Florida at http://www.usdoj.gov/usao/fls.